How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $575.44 | Professional | None | $346.74 | $489.78 | $575.44 |
CareFirst Setting Professional Modifier None Typical Low $338.84 Median $380.19 Typical High $380.19 | Professional | None | $338.84 | $380.19 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,659.59 Typical High $2,754.23 | Facility | None | $446.68 | $1,659.59 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $870.96 | Professional | None | $323.59 | $501.19 | $870.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $1,023.29 | Professional | None | $562.34 | $645.65 | $1,023.29 |
United Setting Facility Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,570.40 | Facility | None | $758.58 | $1,380.38 | $2,570.40 |
United Setting Professional Modifier None Typical Low $288.40 Median $489.78 Typical High $1,122.02 | Professional | None | $288.40 | $489.78 | $1,122.02 |
Wellpoint Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $870.96 | Professional | None | $331.13 | $331.13 | $870.96 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $229.09 Typical High $288.40 | Professional | 52 · Reduced service | $173.78 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $91.20 Typical High $114.82 | Professional | 53 · Discontinued | $69.18 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $338.84 Typical High $436.52 | Professional | 54 · Surgery only | $257.04 | $338.84 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $67.61 Typical High $87.10 | Professional | 55 · Aftercare only | $51.29 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $45.71 Typical High $57.54 | Professional | 56 · Pre-op care only | $34.67 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $316.23 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $239.88 | $316.23 | $407.38 |
Where Maryland sits
The same service costs 5.2 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Maryland· 46th of 51
$447
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.